DR.BASIL SHAMMA's Page

A 22-year-old clerical worker presented to the Emergency Department complaining of severe chest pain.

The pain started suddenly while sitting at his desk in work. He described the pain as being located in the centre of his chest, radiating directly backwards through to his back between the shoulder blades. The pain was not exacerbated by deep inspiration or by position and was not associated with dyspnoea. He had been known to have a heart murmur since childhood but was not under regular… Continue

A 73-year-old woman collapses on the ward just 24hrs post permanent pacemaker insertion whilst waiting for her daughter to collect her. She had been stable after the procedure, which was performed for collapse and episodes of complete heart block on her 72hr tape. On examination she has a fever of 37.8oC, and is hypotensive at 88/50 mmHg, with a thready pulse of 110/min. Her JVP seems to increase with inspiration.



Investigations;



Hb 10.8 g/dl

WCC 8.8 x109/l

PLT… Continue

A 42-year-old woman presents with pins and needles in her hands and feet. She incidentally describes weight loss and offensive smelling stool. She has a history of diverticular disease and anaemia. She is a non-smoker and non-drinker. She eats red meat. On examination, the power and tone in her legs are normal. There are exaggerated knee jerks and absent ankle jerks. Joint position and vibration sense are absent below her ankles. The plantar responses are extensor.…



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Echocardiographic Epicardial Fat: A Review of Research and Clinical Applications

Monday, November 30, 2009, 4:00:00 PM | Gianluca Iacobellis, Howard J. Willens

Epicardial fat plays a role in cardiovascular diseases. Because of its anatomic and functional proximity to the myocardium and its intense metabolic activity, some interactions between the heart and its visceral fat depot have been suggested. Epicardial fat can be visualized and measured using standard two-dimensional… Continue